The recent Johns Hopkins study showing how asthma is affected by race, ethnicity and income ("Poverty, race drive asthma rates more than city living," Feb. 5) dramatically illustrates the importance of addressing asthma through a comprehensive plan that includes education, medication management, monitoring of symptoms and control of environmental triggers. The Department of Health and Mental Hygiene is working with partners to address asthma comprehensively, including the environmental factors that can trigger it.
Evidence shows that children whose conditions are effectively managed by appropriate medication and control of environmental triggers have better outcomes including fewer symptoms, fewer hospitalizations and fewer missed school days. Common triggers in the home include environmental tobacco smoke, dust mites and cockroaches, mold, household chemicals and pesticides and pet hair and dander. These triggers often can be inexpensively controlled through education and such low-cost supplies as mattress and pillow covers. Appropriate medication use is best ensured by following the child's "Asthma Action Plan" which documents for caregivers, school nurses, child care providers and pharmacists exactly how the child should be monitored and treated when he or she has increased symptoms.
The Department's Asthma Control Program is working with a broad coalition of stakeholders to improve asthma outcomes and to decrease health disparities in Maryland. One promising area is the demonstrated link between improvements in housing conditions and improvements in asthma. Continuing our progress in smoking-cessation efforts, developing innovative models to address environmental triggers and increasing the use of asthma action plans to improve medication management will all help to reduce asthma's impact on children's health and readiness to learn.
Van T. Mitchell, Baltimore
The writer is secretary of the Maryland Department of Health and Mental Hygiene.